Find detailed directions on where to return forms and contact information for assistance at the bottom of this page.

Immunization Record Request Form

Use this form to request a copy of your immunization record or to request a copy for your child.

You can also get a copy of your record through your doctor/your child’s pediatrician, or the Local Health Department. Adults 18+ can access their immunization records electronically via the Michigan Immunization Portal. NOTE: You can not access a child’s record through the portal.

Request to Change Information Form

Use this form to request a legal name change, merge duplicate records, or update an address, date of birth, sex, or spelling in an immunization record. The form must be completed by the record owner or their parent/legal guardian. Supporting legal documentation is required for all requests.

If you plan to request your record through the Michigan Immunization Portal, the address you enter in the portal must match the address in your MCIR record.

Changes to your MCIR record may take up to 24 hours to be reflected in the portal.

Participation in MCIR Reporting/Opt-Out

Use this form to object to the reporting requirements of MCIR (opt out of MCIR reporting) or to rescind a previous objection (opt back into MCIR reporting) for you or your child.

Opting out of MCIR reporting means your immunization record is hidden from healthcare providers including doctors, your child’s pediatrician, hospitals, and Local Health Departments. This does not waive immunization requirements for school/childcare. The parent/legal guardian is responsible for providing immunization information or a certified waiver in another format. For information on waivers, contact your Local Health Department.

 

Return Completed Immunization Record Request Forms (please allow up to 14 business days for processing):
Email: MDHHS-ImmunizationRecords@michigan.gov
Fax: 517-335-9855
Mail: MDHHS-Immunization Program, PO Box 30195, Lansing, MI 48909

Return Completed Request to Change Information and Participation in MCIR Reporting Forms (please allow up to 3 business days for processing):
Email: MDHHS-MCIRHelp@michigan.gov
Fax: 517-763-0370

For assistance with getting a child’s immunization record, contact your child’s pediatrician or your county’s Local Health Department.

For assistance with MCIR, the Michigan Immunization Portal, or form questions, contact the MCIR Help Desk:
Phone: 888-243-6652
Email: MDHHS-MCIRHelp@michigan.gov
MILogin: 877-932-6424, option 5 for password reset

MCIR Help Desk Hours of Operation:
Phone: Monday – Thursday 10AM – 12PM and 1PM – 4PM
Email: Monday – Friday 8AM – 4:30PM